Philip Steven Gura, D.C.

Individual provider Active NPI Sports Physician Chiropractor · East Rockaway, NY

NPI 1104914191 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104914191
Entity type
Individual (NPI type 1)
Primary specialty
Sports Physician Chiropractor 111NS0005X
License
X005605-1 (NY)
Practice address
559 Atlantic Ave
East Rockaway, NY 11518-1530
Phone
(516) 593-8333
Fax
(516) 593-8344
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Chiropractic
Education
New York Chiropractic College, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

559 Atlantic Ave
East Rockaway, NY 11518-1530
Phone (516) 593-8333

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040719000948 NY Practitioner - Chiropractic 2769461177 Practice locations: East Rockaway, NY

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
X005605-1NYMDSports Physician Chiropractor
005605NYMDOptician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X X005605-1 NY Yes

Addresses

Primary practice location

559 Atlantic Ave
East Rockaway, NY 11518-1530

Mailing address

559 Atlantic Ave
East Rockaway, NY 11518-1530
Phone (516) 593-8333

Other identifiers

IdentifierTypeStateIssuer
P00123334OtherPALMETTO GBA
P3204341OtherOXFORD HEALTH PLANS
X6F91OtherNYBLUE CROSS BLUESHIELD
808342OtherNYMANAGED PHYSICAL NETWORK
5897788OtherNYGHI
C05605-3OtherNYWORKERS COMPENSATION

Other providers in East Rockaway, NY

All providers in East Rockaway, NY · Sports Physician Chiropractor in New York

Sources for this page

Verify at the official NPI Registry.